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Re: 4 month old only transfering 2 oz at breast

Thanks so much Meg!

I didn't mean to say that you were suggesting weaning the supplement. Our IBCLC wants us to start weaning it because she thinks he likely has bottle preference and doesn't need as much supplement as he is taking. I called today and have a scale coming this week so we will be able to do weighted feeds at home to get a better assessment of how much supplement he really needs.

In terms of milk production, I am BFARing but seems to make enough milk (I am on domperidone). Initially I think my hormonally driven milk supply was good although around 8-10 weeks (when my hormones changed) my milk supply dropped dramatically which I think was due to poor milk transfer and decreased demand due to TT. We had my DS's PTT and ULT revised at 8 weeks, which was likely the reason for his poor milk transfer. Now it's so hard to tell if he still has poor transfer or if he is just used to the bottle.

I really appreciate your comment about supplementing with formula. Yes, we all know that breast is best, which is why I am still here trying to figure out how to get back to the breast. At the same time, the insane schedule of nursing, supplementing and pumping is so miserable and I have been doing that now for 2 months. Your comment made me feel like I am still an important part of this nursing relationship, when so often it seems like us moms are expected to sacrifice everything for these little ones, even if it's to our own detriment. Obviously I want what is best for my son, but a happy mom is also what is best for him.

Re: 4 month old only transfering 2 oz at breast

If I increase our nursing frequency, decrease the supplement and decrease the pumping, do you think I have a hope of getting back to EBF?

YES!!! I DO THINK THAT.

Originally Posted by @llli*lllmeg

Just to be clear, I did not suggest stop supplementing. If baby can not get enough via nursing, then you have to supplement. I do think supplementing may not be needed if you nursed more often and, if needed, could be done in a more breastfeeding supportive way. I suggested stop pumping, because the pumping is making you so miserable you are losing hope after working so hard. This is unfortunately pretty common. I wanted to suggest an alternative..
if you are feeding your baby an extra ounce or two every feeding, then you can not call what you are doing cue feeding. You also cannot truly accurately gage milk intake in that case because your baby may have only taken 2 ounces (which is not really all that bad anyway) because he was not very hungry. What a baby takes from a bottle does not mean much in terms of hunger. But a baby will stop nursing when he is done, unless baby wishes to nurse to sleep or something.
And while it is certainly a judgement call you will need to make, I would rather see you supplement with formula (if needed) than prematurely end your nursing relationship with your baby because pumping is making you so miserable.

I AM suggesting that she wean from the supplements. And I think she can. Not Overnight. But 1 supplement every 3-2 days that is then replaced by a nursing session is very doable IMO. I would NOT use formula when you are making enough milk. I want you to also be open to the idea that your child is NOT having a problem transferring milk. Because 2oz is a normal amount to feed. He is having a problem QUEING his feeds because he is being overfed.

Originally Posted by @llli*mrssqueegy

Thanks so much Meg!
I didn't mean to say that you were suggesting weaning the supplement. Our IBCLC wants us to start weaning it because she thinks he likely has bottle preference and doesn't need as much supplement as he is taking.

I agree with this on both counts. Nipple preference but also the overfeeding Which is an issue. Is it safe to say that she recommended this and you took it to mean that you are doomed? So you started to give up? Because I don't think she meant that. I certainly don't think that.

Originally Posted by @llli*mrssqueegy

In terms of milk production, I am BFARing but seems to make enough milk (I am on domperidone). Initially I think my hormonally driven milk supply was good although around 8-10 weeks (when my hormones changed) my milk supply dropped dramatically which I think was due to poor milk transfer and decreased demand due to TT. We had my DS's PTT and ULT revised at 8 weeks, which was likely the reason for his poor milk transfer. Now it's so hard to tell if he still has poor transfer or if he is just used to the bottle.

I don't think he has poor transfer ANYMORE. I think he isn't transferring at the breast often enough.

Originally Posted by @llli*mrssqueegy

I really appreciate your comment about supplementing with formula. Yes, we all know that breast is best, which is why I am still here trying to figure out how to get back to the breast. At the same time, the insane schedule of nursing, supplementing and pumping is so miserable and I have been doing that now for 2 months. Your comment made me feel like I am still an important part of this nursing relationship, when so often it seems like us moms are expected to sacrifice everything for these little ones, even if it's to our own detriment. Obviously I want what is best for my son, but a happy mom is also what is best for him.

YOU ARE an important part of the nursing relationship. It doesn't happen without you. And if there is a need to supplement, certainly SOME breastmilk is better than none. But you ARE doing it! I want you to change your outlook on this. I understand that what you are doing is hard. Most of motherhood is really. It's more hard than not. Forever. At least until they move out. It changes as they get older. But it doesn't go away. And yeah it IS A ton of sacrifice. But in this particular instance I am not asking you to sacrifice anything. I am asking you to trust the process. So far everything you have been told about supply and demand has been true. So instead of dropping supplements with plans to dry up, do with by replacing supplements with MORE nursing sessions. Don't you see? If you DON'T Offer him MORE than DOUBLE what he is taking in on his own, then he will be hungrier sooner and eventually he may take in MORE at ALL his feeds. Let go of the idea that you are failing or that your baby is. But also don't look for a reason to fail. You are doing this. Keep doing it. Just do it differently.
I repeat I ABSOLUTELY think you CAN get the baby to breastfeed exclusively or possibly with only ONE supplemental feeding a day. (The one you pump at night.) And I think you owe it to your baby to at least try.

Re: 4 month old only transfering 2 oz at breast

So last night we had a little nursing vacation in the living room on the LazyBoy. We nursed and napped and watched TV for several hours. He took less supplement and seemed pretty content.

This morning we tried your suggestion djsmom and did skin to skin in bed. He fusses a bit for his bottle, but I just switched sides when he did. After 30 minutes, he came off on his own and seemed satisfied. We did not offer the bottle. He is now contently playing. I am interested in seeing when he cues to eat again.

Seems like we are on the right track. We have our scale coming this week, just to make us feel a little better about weaning the supplement, but will continue to wean slowly based on cues.

Re: 4 month old only transfering 2 oz at breast

OK. I am ALSO curious. And this morning when you did skin to skin time did you NOT supplement? If so I would NOT pump one time today. Think about it Mama. If you let one session go that is only 3oz less. And would still leave him at 32 oz a day which is ENOUGH FOR SURE. Let one session go. And rework it. I know you are worried about your supply taking a hit. It's a valid concern. I just think if you add in one nursing session INSTEAD, it won't really be a hit. And the he will need to be supplemented less and on and on. And the cycle will become a positive one instead of a viscous cycle.

Re: 4 month old only transfering 2 oz at breast

No, we did not supplement when we did the skin to skin. I totally get what you are saying with the pumping. Even though I hate pumping, I am emotionally attached to it because it was how I got my supply back up. I will cut down my pumping, but I am not sure I am quite ready to let it go yet. Soon though, I promise!

Re: 4 month old only transfering 2 oz at breast

SLOWLY. GRADUALLY. One session at a time. But listen Mama, here's my point. I would have you give up one session at a time and feed more than just assume that no longer pumping means that you no longer can exclusively give breastmilk. That it's NOT the road to exclusive nursing. Because I think it CAN BE. ABSOLUTELY. THAT is my point. If you aren't ready today to experiment with letting go of one session today I understand. (But I want you to try soon. Just one. And see what happens.) BUT when you ARE, I want you to think in terms of simply trading it in. For more time at the breast. You make enough milk. MORE than enough. He is being fed to much per feed. Pump less feed more. You can do it.

Re: 4 month old only transfering 2 oz at breast

It sounds as if we are in agreement with your lc! That's a relief.

I am more and more convinced that, when it comes to weaning from supplements, pumping, or both, mom having confidence-trust- in the process as djs.mom said, (which also means, having confidence/trusting in her own body and her baby) is the biggest hurdle. And it can be a really big wall. I have seen the lack of confidence trip up mom after mom. You have kept breastfeeding through some really serious, difficult breastfeeding issues, the kind that have sent many a mom to eff right quick. In other words, you have done amazing. Yet the last straw for your confidence was something so small-a before and after nursing weight check that showed a milk transfer of less than you were hoping.

Looking at your first post on this thread to your last, you have taken a huge leap in your confidence. That is so great! Remember there may be ups and downs. Please be cautious about little things setting your confidence back (a not great nursing session, a fussy period, etc.) And be cautious using the scale. If your instincts tell you things are going well when it arrives, consider leaving it in the box. If the scale is going to help you gain confidence, great. Just proceed with caution.

I think you hit the nail on the head. pumping and supplementing-even when 100% needed, have the tendency to, in her mind (not in reality) dissasociate mom from her baby and her body and the natural processes of nursing. So the weaning from supplements and pumping will include making a shift in your thinking, as djs.mom has been saying. The typical breastfeeding mom does not constantly weight check her 4 month old baby. kwim? If baby is hungry or fussy or anything, just if she feels like it, she just offers to nurse again, and if baby won't nurse, she does something else and offers again a bit later. She does this without even thinking about it. She does not think about how much milk is transfering. Usually she does not even think about how often baby is nursing. You know with some pretty good accuracy exactly how much milk your body can produce each day-so you, unlike most mothers, know for a fact it is enough, probably more than enough. I have absolutely no idea how much milk I produce for my now 6 month old and I never did. kwim? Yet I have total confidence in my milk production and you struggle. Yes our situations are very different, of course. You have the concerns of your history, I get it. But at this point we are not so different, biologically-as you make as much or more milk than any exclusively breastfeeding mom of any 4 month old! The difference is, your brain has been trained to constantly be thinking in terms of 'how much milk' and 'how much weight' which is needed when a mom cannot produce enough/baby is not gaining well, of course. But now that you are back on track with that, part of this will be training your brain away from that. Which is why the scale worries me just a tad. I hope I am making sense.

Re: 4 month old only transfering 2 oz at breast

I completely agree Meg. I have a totally unnatural association with his feeding and weight. Part of it comes come his low weight gain in the beginning and feeling guilty about him not getting enough food. I never want him to have that again, so I feel the need to be able to see exactly what he is getting (bottles, weighed feeds, etc.). It is so hard to learn to trust our nursing relationship again, especially when I have worked so hard to get here. Sometimes I can't even believe that we are still going!

On kellymom, they talk about weaning formula supplements 1 oz per day, but mention that BM supplements can be weaned more quickly. Do you have a suggestion on how quickly we can wean? I don't want to go too fast, but I would like to get back to EBF as soon as possible. I will be asking my LC as well.

Re: 4 month old only transfering 2 oz at breast

On kellymom, they talk about weaning formula supplements 1 oz per day, but mention that BM supplements can be weaned more quickly. Do you have a suggestion on how quickly we can wean? I don't want to go too fast, but I would like to get back to EBF as soon as possible. I will be asking my LC as well.

please talk to your lc about this. I really cannot give specific suggestions in this spere. However I will say that the kellymom guidelines are just that-guidelines, not rules, and imo are extremely cautious. I think-i have not read them for a while- they are more for the mother who is still building production, and is weaning baby from formula supplements. In other words, I would not be surprised if you can move more quickly than that, depending on how often your baby will nurse.

Re: 4 month old only transfering 2 oz at breast

Are you still considering getting the scale for home use? I found it so helpful as I transitioned away from supplements. Breastfeeding is a confidence game, to a large extent- and while the scale interferes with the naturalness and ease of breastfeeding, it has the potential to provide a confidence boost. Every time I saw that my LO had taken in 2 oz or more at the breast, I knew that I didn't need to supplement, and I learned to identify what a good feeding looked/sounded/felt like.